A Placebo-Controlled Trial of Riboflavin for Enhancement of Ultramarathon Recovery.

Background: Riboflavin is known to protect tissue from oxidative damage but, to our knowledge, has not been explored as a means to control exercise-related muscle soreness. This study investigated whether acute ingestion of riboflavin reduces muscle pain and soreness during and after completion of a 161-km ultramarathon and improves functional recovery after the event.

Methods: In this double-blind, placebo-controlled trial, participants of the 2016 161-km Western States Endurance Run were assigned to receive a riboflavin or placebo capsule shortly before the race start and when reaching 90 km.

The influence of hydration state on thermoregulation during a 161-km ultramarathon.

It is advised that individuals should avoid losing >2% of their body mass during exercise in order to prevent hyperthermia. This study sought to assess whether a loss of >2% body mass leads to elevations in core temperature during an ultramarathon. Thirty runners agreed to take part in the study.

Determinants of recovery from a 161-km ultramarathon.

The primary study objective was to identify determinants of short-term recovery from a 161-km ultramarathon. Participants completed 400 m runs at maximum speed before the race and on days 3 and 5 post-race, provided a post-race blood sample for plasma creatine kinase (CK) concentration, and provided lower body muscle pain and soreness ratings (soreness, 10-point scale) and overall muscular fatigue scores (fatigue, 100-point scale) pre-race and for 7 days post-race. Among 72 race finishers, soreness and fatigue had statistically returned to pre-race levels by 5 days post-race; and 400 m times at days 3 and 5 remained 26% (P = 0.

A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery.

Study Design Randomized controlled trial. Background Postexercise recovery techniques are widely used, but little research has examined their effectiveness. Objectives To examine the effectiveness of massage and pneumatic compression on recovery from a 161-km ultramarathon.

Does oral buffered sodium supplementation reduce nausea and vomiting during an ultramarathon?

This work examines whether nausea or vomiting during an ultramarathon are due to a fluid or electrolyte imbalance, and if these symptoms can be reduced through the use of buffered sodium supplements. Starters (n = 376) of a 161.3-km ultramarathon underwent body weight measurements, 74.

Is Sodium Supplementation Necessary to Avoid Dehydration During Prolonged Exercise in the Heat?

The primary purpose of this work was to gain further insight into the need for sodium supplementation for maintenance of appropriate hydration during prolonged exercise under hot conditions. Participants of a 161-km ultramarathon (ambient temperature reaching 39° C) underwent body weight measurements immediately before, during, and after the race, and completed a postrace questionnaire about supplemental sodium intake and drinking strategies during 4 race segments. The postrace questionnaire was completed by 233 (78.

Sodium Intake During an Ultramarathon Does Not Prevent Muscle Cramping, Dehydration, Hyponatremia, or Nausea.

Background: Ultramarathon runners commonly believe that sodium replacement is important for prevention of muscle cramping, dehydration, hyponatremia, and nausea during prolonged continuous exercise. The purpose of this study was to measure total sodium intake to determine if these beliefs are supported.

Methods: Participants of a 161-km ultramarathon (air temperature reaching 39 °C) provided full dietary information during the race, underwent body weight measurements before and after the race, completed a post-race questionnaire about muscle cramping and nausea or vomiting during the race, and had post-race plasma sodium concentration measured.

Nausea is associated with endotoxemia during a 161-km ultramarathon.

This study explored possible contributing factors to gastrointestinal distress, including endotoxemia, hyperthermia, dehydration and nutrition, during a 161-km ultramarathon. Thirty runners participated in the study and 20 finished the race. At three checkpoints and the finish, runners were interviewed to assess the incidence and severity of 12 gastrointestinal symptoms and to determine dietary intake.

Muscle Cramping During a 161-km Ultramarathon: Comparison of Characteristics of Those With and Without Cramping.

Background: This work sought to identify characteristics differing between those with and without muscle cramping during a 161-km ultramarathon.

Methods: In this observational study, race participants underwent body weight measurements before, during, and after the race; completed a post-race questionnaire about muscle cramping and "near" cramping (controllable, not reaching full-blown cramping), drinking strategies, and use of sodium supplementation during four race segments; and underwent a post-race blood draw for determination of serum sodium and blood creatine kinase (CK) concentrations.

Results: The post-race questionnaire was completed by 280 (74.

Gastrointestinal distress is common during a 161-km ultramarathon.

This study examined the incidence, severity, and timing of gastrointestinal (GI) symptoms in finishers and non-finishers of the 161-km Western States Endurance Run. A total of 272 runners (71.0% of starters) completed a post-race questionnaire that assessed the incidence and severity (none = 0, mild = 1, moderate = 2, severe = 3, very severe = 4) of 12 upper (reflux/heartburn, belching, stomach bloating, stomach cramps/pain, nausea, vomiting) and lower (intestinal cramps/pain, flatulence, side ache/stitch, urge to defecate, loose stool/diarrhoea, intestinal bleeding/bloody faeces) GI symptoms experienced during each of four race segments.

Sodium Supplementation and Exercise-Associated Hyponatremia during Prolonged Exercise.

Purpose: This work examines whether sodium supplementation is important in prevention of hyponatremia during continuous exercise up to 30 h and whether any distinguishing characteristics of those developing hyponatremia could be identified.

Methods: Participants of the 161-km Western States Endurance Run underwent body weight measurements before, during, and after the race, completed a postrace questionnaire about drinking strategies and use of sodium supplementation during four race segments, and underwent analysis of postrace serum sodium concentration.

Results: The postrace questionnaire was completed by 74.

Hydration strategies, weight change and performance in a 161 km ultramarathon.

To examine controversies about hydration strategies, participants (383 starters) of a 161 km ultramarathon (maximum temperature 39.0°C) underwent body weight measurements before, during and after the race; and completed a post-race questionnaire on drinking strategies and sodium supplementation use during 4 race segments. Drinking to thirst was the most common (p < 0.

Exercise-associated hyponatremia with exertional rhabdomyolysis: importance of proper treatment.

Background: Proper acute management of exercise-associated hyponatremia (EAH) has been known for decades, yet this information has not been uniformly implemented. Since treatment of EAH with isotonic fluids can result in delayed recovery and death, it is important that proper acute management in the field and hospital be utilized.

Case Report: We describe a participant of the 161-km Western States Endurance Run (WSER) who presented with seizure after dropping out at 145 km.

Efficacy of oral versus intravenous hypertonic saline in runners with hyponatremia.

Objectives: To determine more conclusively whether intravenous (IV) administration of 3% saline is more efficacious than oral administration in reversing below normal blood sodium concentrations in runners with biochemical hyponatremia.

Design: Randomized controlled trial.

Methods: 26 hyponatremic race finishers participating in the 161-km Western States Endurance Run were randomized to receive either an oral (n=11) or IV (n=15) 100mL bolus of 3% saline.

The need for salt: does a relationship exist between cystic fibrosis and exercise-associated hyponatremia?

Salt replacement is often recommended to prevent exercise-associated hyponatremia (EAH) despite a lack of evidence to support such practice. Exercise-associated hyponatremia is known to be a complex process resulting from the interplay of hydration, arginine vasopressin, and sodium balance. Although evidence suggests overhydration is the dominant pathophysiologic factor in most cases, the contributions of sweat sodium losses remain unclear.

Characteristics of 161-km ultramarathon finishers developing exercise-associated hyponatremia.

This study sought to identify runner characteristics or symptoms that could distinguish those finishers developing exercise-associated hyponatremia (EAH) from those not developing EAH in a 161-km ultramarathon. Of 310 finishers, 207 (67%) underwent postrace blood studies. Twelve (6%) finishers had EAH (blood sodium range 131-134 mmol/L).

The effects of an acute dose of Rhodiola rosea on endurance exercise performance.

The purpose of this study was to determine the effects of an acute oral dose of 3 mg·kg(-1) of Rhodiola rosea on endurance exercise performance, perceived exertion, mood, and cognitive function. Subjects (n = 18) ingested either R. rosea or a carbohydrate placebo 1 hour before testing in a double-blind, random crossover manner.

The effect of physiology and hydration beliefs on race behavior and postrace sodium in 161-km ultramarathon finishers.

Purpose: To determine if beliefs about physiology and rehydration affect ultramarathon runners' hydration behaviors or if these beliefs increase the risk for exercise-associated hyponatremia (EAH).

Methods: Participants of the 2011 161-km Western States Endurance Run completed a prerace questionnaire, prerace and postrace body-mass measurements, and postrace assessment of serum sodium ([Na⁺]).

Results: Of 310 finishers, 309 (99.

Exercise-associated hyponatremia and hydration status in 161-km ultramarathoners.

Purpose: This work combines and reanalyzes 5 yr of exercise-associated hyponatremia (EAH) research at 161-km ultramarathons in northern California with primary purposes to define the relationship between postrace blood sodium concentration ([Na]) and change in body weight; to examine the interactions among EAH incidence, ambient temperature, and hydration state; and to explore the effect of hydration status on performance.

Methods: Prerace and postrace body weight and finish time data were obtained on 887 finishers, and postrace [Na] was also obtained on a subset of 669 finishers.

Results: EAH incidence was 15.

Urine dipstick analysis for identification of runners susceptible to acute kidney injury following an ultramarathon.

This study examined whether urine dipstick testing might be useful to predict the development of acute kidney injury after an ultramarathon. Participants in the 2011 161-km Western States Endurance Run underwent post-race blood and urine dipstick analyses. Of the 310 race finishers, post-race urine dipstick testing was completed on 152 (49%) and post-race blood also was obtained from 150 of those runners.

Association of gastrointestinal distress in ultramarathoners with race diet.

Context: Gastrointestinal (GI) distress is common during ultrarunning.

Purpose: To determine if race diet is related to GI distress in a 161-km ultramarathon.

Methods: Fifteen (10 male, 5 female) consenting runners in the Javelina Jundred (6.

Increasing creatine kinase concentrations at the 161-km Western States Endurance Run.

Objective: Very high blood creatine kinase (CK) concentrations have been observed among recent finishers of the 161-km Western States Endurance Run (WSER), and it has been suggested that there is a link between rhabdomyolysis and hyponatremia. Therefore, the purpose of this study was to compare CK concentrations of finishers in the 2010 WSER with past values, and to determine whether there was an association between blood CK and sodium concentrations.

Methods: Consenting 2010 WSER finishers provided blood samples at the finish for determination of blood CK and sodium concentrations.

Race diet of finishers and non-finishers in a 100 mile (161 km) mountain footrace.

Objective: To determine if food and fluid intake is related to completion of a 161-km ultramarathon.

Methods: Sixteen consenting runners in the Western States Endurance Run participated in the study. Race diets were analyzed using Nutritionist Pro software.